Provider Demographics
NPI:1356813331
Name:REED, HEATHER MAE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MAE
Last Name:REED
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5247 COUNTY ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:NY
Mailing Address - Zip Code:14821-9527
Mailing Address - Country:US
Mailing Address - Phone:607-346-3443
Mailing Address - Fax:
Practice Address - Street 1:5247 COUNTY ROUTE 125
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:NY
Practice Address - Zip Code:14821-9527
Practice Address - Country:US
Practice Address - Phone:607-346-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318969164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty